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PHM 603- ID Part 2 > HCV Treatment > Flashcards

HCV Treatment Flashcards

1
Q

Sofosbuvir MoA

A

Nucleotide NS5B polymerase inhibitor

SofosBuvir, NS5B

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2
Q

What genotypes does sofosbuvir treat?

A

1-4

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3
Q

Sofosbuvir dose

A

400mg PO QD (used as a backbone for therapies)

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4
Q

Sofosbuvir duration of treatment

A

Up to 48 weeks

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5
Q

Ledipasvir MoA

A

NS5A inhibitor

LedipAsvir (NS5A)

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6
Q

Sofosbuvir/ledipasvir indication (what genotypes)

A

Genotype 1 only (but also treats 4-6?)

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7
Q

Duration of treatment for sofosbuvir/ledipasvir (with and without cirrhosis)

A

12 weeks without cirrhosis

24 weeks with cirrhosis

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8
Q

CrCl requirement for sofosbuvir/ledipasvir

A

CrCl >30ml/min

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9
Q

Duration of treatment for sofosbuvir/ledipasvir when the patient has cirrhosis

A

24 weeks

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10
Q

Sofosbuvir/ledipasvir dosing

A

1 tab PO QD (90mg ledipasvir, 400mg sofosbuvir)

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11
Q

Sofosbuvir ADEs

A

Bradycardia with amiodarone, fatigue, HA, nausea

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12
Q

Velpatasvir MoA

A

NS5A protease inhibitor

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13
Q

Velpatasvir/Sofosbuvir indication (genotypes)

A

1-6

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14
Q

Velpatasvir/sofosbuvir dosing

A

100mg capsule of velpatasvir, 400mg of sofosbuvir QD

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15
Q

Duration of treatment for velpatasvir/sofosbuvir

A

12 weeks with or without cirrhosis

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16
Q

ADEs of velpatasvir/sofosbuvir

A

headache, fatigue

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17
Q

Glecaprevir/pibrentasvir indication (what genotypes)

A

1-6

18
Q

Glecaprevir/pibrentasvir dosing

A

1 tab PO QD with food (100mg glecaprevir, 40mg pibrentasvir)

19
Q

Duration of treatment for glecaprevir/pibrentasvir without cirrhosis

A

8 weeks

20
Q

Duration of treatment for glecaprevir/pibrentasvir with cirrhosis

A

12 weeks

21
Q

ADEs of glecaprevir/pibrentasvir

A

fatigue, headache

22
Q

CIs for glecaprevir/pibrentasvir

A

Severe hepatic impairment, coadministration with atazanavir and rifampin

23
Q

Elbasvir/grazoprevir indication (what genotypes)

A

1 with or without cirrhosis

4

24
Q

Elbasvir/grazoprevir dosing

A

Grazoprevir 100mg, elbasvir 50mg

25
Q

CIs to elbasvir/grazoprevir

A

Moderate-severe hepatic impairment (Child-Pugh B or C), OATP1B1/3 inhibitors, CYP3A inducers and efavirenz

26
Q

ADEs to elbasvir/grazoprevir

A

fatigue, headache, nausea

27
Q

Duration of treatment for elbasvir/grazoprevir for genotype 1 infection

A

12 weeks

28
Q

CrCl Velpatasvir requirement

A

> 30ml/min

29
Q

Duration of treatment for elbasvir/grazoprevir for patients with NS5A polymorphisms and ribavirin

A

16 weeks

30
Q

Treatment of chronic HCV GT1A

A

GLE/PIB x8 weeks
VEL/SOF x12 weeks
LDV/SOF x12 weeks (8 weeks if no cirrhosis, non-Black, HIV and HCV RNA <6 million IU/ml)

31
Q

Alternative treatment for GT1A

A

EBR/GZR x12 weeks without NS5A polymorphism

32
Q

Treatment of GT1B

A

Same treatments as GT1A

33
Q

Treatment of GT 2 and 3

A

GLE/PIB x8 weeks

VEL/SOF x12 weeks

34
Q

Alternatives for GT3 treatment

A

VEL/SOF and RBV x12 weeks (cirrhosis, NS5A RAS Y93H)

VEL/VOX/SOF x12 weeks

35
Q

Treatment of GT 4

A

GLE/PIB x8 weeks
VEL/SOF x12 weeks
LDV/SOF x12 weeks
EBR/GZR x12 weeks

36
Q

Treatment of GT 5 and 6

A

GLE/PIB x8 weeks
VEL/SOF x12 weeks
LDV/SOF x12 weeks

37
Q

Treatment for patients with renal dysfunction (CrCl <30ml/min) with no cirrhosis and high urgency to treat with GT 1a, 1b, and 4

A

EBR/GZR x12 weeks

38
Q

Treatment for patients with renal dysfunction (CrCl <30ml/min) with no cirrhosis and high urgency to treat with GTs 1-6

A

GLE/PIB for 8-16 weeks

39
Q

Drug efficacy/monitoring: 4 week mark

A

CBC, SCr, LFTs, HCV RNA
Stop therapy if >10x increase in ALT or <10x increase with evidence of decompensation
Repeat HCV RNA test at week 6 if positive

40
Q

Drug efficacy/monitoring: 6 week mark

A

HCV RNA if positive at week 4

Stop therapy of 10-fold increase

41
Q

Drug efficacy/monitoring: 12 week mark

A

TSH

Consider HCV and stop most therapies

42
Q

Drug efficacy/monitoring: 24 weeks

A

HCV RNA, assess for SVR

Stop 16-week regimens and check SVR longer

PHM 603- ID Part 2 (21 decks)

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